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NIGERIA 1ST NATIONAL VACCINE SUMMIT

TOWN HALL MEETINGS REPORT 2012

Cover photo: Children perform a dance during the opening ceremony of the 1st National Vaccine Summit. Above: Members of NCWS,FIDA, and students from Taraba State University at Town Hall hosted by the Silver Lining for the Needy Initiative.

Presentation given at the Nasarawa Town Hall hosted by the VaccineNetwork for Disease Control & National Council for Women’s Societies.

Introduction

Vaccines are among the most impactful and cost-effective public health in-

terventions available today. Diseases prevented by vaccines, such as pneumo-

nia, diarrhea, meningitis, and measles constitute about a quarter of the

800,000 child deaths in Nigeria. In addition to protecting health and saving

lives, vaccines also provide economic benefit. In Nigeria, scaling up coverage

of five vaccines (Hib, pneumococcal, measles, pertussis, rotavirus) to 90% is

projected to avert economic loss of $17 billion dollars over the next ten years.

Nigeria has made considerable progress on its routine immunizations pro-

grams, however, there are still some critical gaps. Recent advances include

more than doubling DTP3 coverage (29% to 69%) between 2000 and 2010,

and the introduction of two new vaccines (Men AfriVac and Pentavalent).

However, one million children still failed to receive all their required vac-

cines in 2011. Polio, which had been on the decline, has also begun to

make a comeback. Going forward, Nigeria has a major opportunity to re-

duce child mortality, towards achieving Millennium Development Goal

(MDG) 4, by accelerating access to immunization services.

As part of an ongoing effort to boost immunization, Nigeria hosted its 1st

National Vaccine Summit in Abuja in April, 2012. The meeting hosted a

broad range of local and international partners to galvanize both high-

level and grassroots support for immunization in Nigeria. In preparation

for the event, members of the Summit’s National Planning Committee held

a series of Town Hall meetings in order

to provide a forum for Nigerians to high-

light the vaccine-related issues relevant

to their communities.

This report focuses on the series of eight

Town Hall meetings that were held

across the six geopolitical zones. Six of

the Town Hall events convened a general

audience, while the remaining two tar-

geted Nigeria’s youth and public-private

sector partnerships. Discussions at the

Town Halls included the public’s percep-

tion of disease and immunization, cur-

rent challenges with immunization, and

recommendations for improving access

and uptake of immunization services. A

summary of points from each event was

presented as part of the keynote address

at the National Vaccine Summit, giving

a voice to Nigerians from diverse occu-

pations and circumstances who other-

wise would not have been heard.

Table of Contents

• Immunization in Nigeria ...........................................................................................2

• Nigeria’s 1st National Vaccine Summit ......................................................................4

• Outcomes of the Summit ...........................................................................................5

• Listening to Nigeria: The Summit Town Hall Series..................................................6

• South West Zone, Ile-Ife, Osun State .........................................................................8

• North Central Zone, Lafia, Nasarawa State............................................................10

• South East Zone, Owerri, Imo State ........................................................................12

• North West Zone, Kaduna, Kaduna State................................................................13

• Public & Private Sector Partners, Abuja, Federal Capital Territory .......................14

• South South, Benin City, Edo State..........................................................................16

• North East Zone, Jalingo, Taraba State ...................................................................18

• North East Zone, Maiduguri, Borno State...............................................................19

• Looking forward ......................................................................................................20

• Partners....................................................................................................................21

Dance performance at the Taraba Town Hall hosted by Silver Lining for the Needy Initiative.

2N I G E R I A 1 S T N A T I O N A L V A C C I N E S U M M I T

Immunization in Nigeria

According to recent WHO estimates, 868,000 children under the age of five

years die in Nigeria every year. As a result of both a high child mortality rate

and a large population, Nigeria is second only to India in the total number of

childhood deaths. A significant proportion of these deaths are caused by vac-

cine-preventable diseases like pneumonia, diarrhea, meningitis, and measles.

Despite systemic weaknesses, Nigeria has made extraordinary progress in im-

proving access to vaccination in recent years. Coverage for all vaccines rose

substantially over the 2000-2010 decade. According to WHO/UNICEF esti-

mates, three-dose diphtheria, tetanus, and pertussis vaccine (DTP3) coverage

more than doubled, increasing from 29% to 69% during this period.

Nigeria conducted an important mass campaign in late 2011 to deliver a new

meningitis vaccine. In 2012, Nigeria began a three-year, phased rollout of the

pentavalent vaccine, which protects against diphtheria, tetanus, pertussis,

hepatitis B, and Haemophilus influenza b. Introduction of the pneumococcal

and rotavirus vaccines are expected to begin in 2013 and 2017 respectively.

Efforts to eradicate polio are at an all-time high as the country fights to escape

being one of the three polio endemic coun-

tries in the world.

Beyond reducing child mortality, research

shows that increasing vaccine access will

have a positive impact on Nigeria’s econ-

omy. Researchers at the Johns Hopkins

Bloomberg School of Public Health Inter-

national Vaccine Access Center estimate

that achieving 90% coverage with vaccines

against five diseases (Hib, pneumococcal,

measles, pertussis, rotavirus) would save

more than 600,000 lives and avert U.S. $17

billion in economic losses for Nigeria over

the next ten years, lifting millions out of

the vicious cycle of illness and poverty.

Child Mortality 2010

0

22.5

45

67.5

90

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

BCG DTP1DTP3 HepB3MCV Pol3Yfv

VACCINES

Vaccine Coverage 2011

Liu L, Johnson H, Coursens S, et al. Global, regional, and nationalcauses of child mortality: an updated systematic analysis for 2010with time trends since 2000. Lancet 2012; 379: 2151-61.

WHO, UNICEF. WHO/UNICEF estimates of national immunization coverage. WHOVaccine-preventable diseases: monitoring system. 2012.

3T O W N H A L L M E E T I N G S R E P O R T 2 0 1 2

Averted deaths and costs statistics come from Stack ML, Ozawa S, et al. Estimated economic benefits during the ‘Decade of Vaccines’ include treatment savings, gains in labor productivity. HealthAffairs. 2011; 30(6): 1021-1028.

Volunteers at the event give out prescribed medication. Photo courtesy of Sunny Inah and So-Healthi.

A coalition of international and domestic partners has come

together for the first time in history to support the Nigerian

government on routine immunization to reduce child mor-

tality. It’s clear that reaching this goal will require significant

improvements to vaccine access. Nigeria’s Vaccine Summit

and Town Hall Meetings marked the beginning of a great ef-

fort to make this a reality.

Life and death depend on

whether a child is born in a country

where vaccines are available.

—Mohammad Pate, Minister of State for Health, Nigeria

(quoting Nelson Mandela)

Nigeria’s 1st National Vaccine Summit

On April 16-17, 2012, Nigeria held its first-ever National Vaccine Summit, a

high-level advocacy meeting to promote routine immunization (RI) in Nige-

ria. The Summit brought together over 1,000 stakeholders from multiple sec-

tors including health, education, finance, transportation, and power.

Objectives of the Summit: 1. To sensitize high-level political and business leaders about

how vaccines promote child survival and provide substantial eco-

nomic benefits for Nigeria

2. To declare a Call to Action to reach all Nigerian children with

routine immunization by the year 2015, in order to reduce

child mortality and achieve MDG4

3. To raise pledges of support for RI from Nigerian leaders across

the political, business, traditional, and religious spectrum

4. To establish an action plan and accountability framework to

follow-up on pledges made at the 1st National Vaccine Summit

and execute the Call to Action.

First Lady, Dame Patience Jonathan, receives an award at the 1st National Vaccine Summit.

“With over one million

Nigerian children dying each year

from conditions that can easily be

prevented by vaccination, we all would be

failing in our duties as mothers, parents,

and leaders in the various segments of our

society, if we don’t take this advantage to

do something concrete.”

—Dame Patience Jonathan, First Lady of Nigeria


At the Summit, the First Lady, Dame

Patience Jonathan, urged the creation of

a national fund under a future Nigerian

Alliance for Vaccines and Immunization

(NAVI), a public-private partnership, to

provide vaccine financing from within

the country. She also called for a bian-

nual African Vaccine Summit to meas-

ure progress of vaccination initiatives on

the continent.

Another high priority in the next few

years for Nigeria is the Federal Ministry

of Health’s plan to rollout the pentava-

lent, pneumococcal conjugate, and ro-

Panel session at the 1st National Vaccine Summit.


Outcomes of the Summit

Participants at the 1st National Vaccine Summit.

More information

about Nigeria’s 1st

National Vaccine Summit,

the Town Hall Series, and the

program’s partners can be

found online at:

www.nigeriavaccine

summit.org

tavirus vaccines, which will substantially reduce deaths from pneumonia,

diarrhea, and other diseases. Introduction of pentavalent vaccine began

in 2012, with the others to follow in the coming years.

A Call to Action was made to Nigerian leaders from across political, tradi-

tional, and religious sectors to commit to ensuring excellence at primary

health care facilities in their communities. A list of key points and recom-

mendations was also written, covering governance, financing, service deliv-

ery, health management information systems, human resources, community

participation, partnerships, and research. The principal goal of these efforts

is to achieve universal coverage for all Nigerian children by year 2015.

Dr. Muhammad Pate, Minister of State for Health of Nigeria, speaks at the 1st National Vaccine Summit.

Listening to Nigeria: The Summit Town Hall Series

In the months leading up to the National Vaccine Summit, a series of Town

Hall meetings on immunization were held to give a voice to communities

across Nigeria. The goal of these meetings was to learn community percep-

tions about vaccination and solicit input on Nigeria’s immunization program.

Each meeting was hosted by a local association, company, or civil society or-

ganization active in promoting routine immunization in Nigeria.

In total, there were eight meetings, with at least one Town Hall held for each

geopolitical zone and the federal capital territory. Six of the Town Halls were

focused on RI in a specific zone and two had a special focus, one on Nigeria’s

youth, and the other on public and private sector partnerships.

Participants at these meetings came from a variety of backgrounds, including

youth, students, artisans, market sellers, religious leaders, health professionals,

private companies, government officials, and wives of state governors. During

the course of the meetings, many of these participants pledged to become

ambassadors of immunization in their communities.

Recommendations from the Town Hall meetings included hiring more

health workers, providing better training for health workers, and incen-

tivizing health workers to have more positive attitudes. Participants sug-

gested the need for increased public awareness about the benefits of

routine immunization and the importance of earning the support of tra-

ditional and political leaders. Also highlighted were the lack of access to

immunization services in rural areas and a desire for more health centers.

Shortages of vaccines and breakdowns and inadequacies in the vaccine

delivery system were another concern. All were in agreement about the

need for a Call to Action for immunization.

The following pages summarize the

Nigerian voices captured at each Town

Hall event.

The Town Hall events across Nigeria• Ife-Ife, Osun State –

January 22, 2012 – Paediatric

Association of Nigeria

• Lafia, Nasarawa State –

March 15, 2012 – Vaccine Network

for Disease Control / National Coun-

cil for Women’s Societies

• Owerri, Imo State –

March 22, 2012 – Health Reform

Foundation of Nigeria

• Kaduna, Kaduna State –

April 13, 2012 – Women of Purpose

• Abuja, FCT –

March 28, 2012 – National Primary

Healthcare Development Agency

• Benin City, Edo State –

March 29, 2012 – Solina

Health Limited

• Jalingo, Taraba State –

April 4, 2012 – Silver Lining for

the Needy Initiative

• Maiduguri, Borno State –

April 7, 2012 – Evolve Worldwide


Attendees at the Nasarawa State Town Hall hosted by Vaccine Network for Disease Control / National Council for Women’s Societies.

Drummers perform at the Nasarawa State Town Hall hosted by Vaccine Network for Disease Control / National Council for Women’s Societies.

A performance at the Nasarawa State Town Hall hosted by Vaccine Network for Disease Control / National Council for Women’s Societies.

Youth speak out at the Nasarawa State Town Hallhosted by Vaccine Network for Disease Control /National Council for Women’s Societies.


A summary of

recommendations from

the Town Hall series was

presented as part of the

Keynote address at

Nigeria’s 1st National

Vaccine Summit.

CALABAR

LAGOS

NASARAWAFCT

IBADAN

Town Hall events were held at eight sites around Nigeria.

South West Zone

Ile-Ife, Osun StateHosted by the Paediatric Association of Nigeria

January 22, 2012

For the South West Zone, the Paediatric Association of Nigeria (PAN) hosted

the Town Hall event in Ile-Ife, Osun State. Dr. Dorothy Esangdego, President

of PAN, moderated focus group sessions with close to 100 participants to dis-

cuss local perspectives on the issues surrounding immunization. Participants

had varying levels of education and were opinion leaders in various groups,

such as the motorcyclists and drivers associations, religious and traditional

leaders, traders, and students.

The meeting had a lively discussion about the reasons why children are not

receiving the proper immunizations. At the family level, a few suggestions

were: families don’t know or forget that immunization is needed, there is a

belief that immunization will be harmful to the child, other purchases and

activities are prioritized over immunization, and more broadly, poverty.

Several logistical reasons for why children go unvaccinated were also cited,

including poor roads, unavailability of vaccines, high cost of transportation,

long wait times at health centers, and inadequate coverage of health services.

Perceived benefits/risks of routine immunization in the South West ZoneBenefits

• Reduction of childhood diseases

• Healthier children

• Saves money on hospital bills

• Makes children more helpful at

home

• Peace of mind for parents

Risks

• Incorrect administration

• Fever

• Sickness or swelling off the body

• Paralysis

• Death

Participants listen to a presentation at the in Osun State Town Hall hosted by Paediatric Association of Nigeria.


Town Hall

Conclusion:

“We support immunization

in this community

because of the

benefits.”


List of recommendations made at the Town Hall:• Hire more workers to administer vaccines

• Provide better training for health workers who administer the

vaccines

• Encourage health workers to have a friendly attitude to mothers

• Ensure the vaccines are available all the time

• Ensure immunization gets to those in the villages

• Reduce waiting time for mothers

• Provide transportation for mothers to clinic on immunization days

• Give mothers incentives to get their children immunized

(e.g. insecticide treated nets, diapers, etc.)

• Increase awareness campaigns on immunization focusing on issues of

overdose and multiple uptakes at different venues e.g. school, church,

mosque, or health center

Questions & Answers with the South West Zone

What are the benefits of immunization? Q:It reduces sickness and death, makes parents have peace of mind. Parents will not need to spend money on hospital bills.A:

What do you know about routine immunizations?Q:It prevents diseases like measles, yellowfever, polio, rashes, and cough.A:

Do you have enough health facilities in your communities? Q:The facilities are not enough, especially in the villages. The workers are few and this makes our wives spend the whole day in the clinic.

Sometimes the vaccines are not available and this discourages the mothers.

The roads are bad and transportation [to the clinic] is expensive.

A:

North Central Zone

Lafia, Nasarawa StateHosted by the Vaccine Network for Disease Control &

National Council of Women’s Societies

March 15, 2012

Nigeria’s North Central Zone held their Town Hall Meeting

on immunization in Lafia, Nasarawa State, hosted by the

Vaccine Network for Disease Control & National Council

of Women’s Societies. The meeting had 250 participants rep-

resenting all seven states of the zone (Kwara, Kogi, Plateau,

Benue, Niger, Nasarawa, and the Federal Capital Territory).

Participants said that the biggest challenges to rou-

tine immunization in Nigeria are religious and

cultural beliefs of the various communities in

the country. Also of concern were lack of im-

munization awareness, a shortage of vaccines

in many areas, lack of proper maintenance of

the cold chain infrastructure, and the lack of

skilled health workers.

Children attending the Nasarawa State Town Hall hosted by VaccineNetwork for Disease Control & National Council for Women’s Societies.


“A participant told

his story of how he took

his sick child to the hospital

and the child was not treated, so

when the health workers came to

his home to immunize his child,

he refused to let them touch

the child.”

“Attendees pledged

to be ambassadors of

immunization, promising

to get involved in

neighbor to neighbor

awareness.”


Suggestions from the meeting included: • Opening additional local health

facilities

• Creating awareness of routine

immunization

• Training health workers to better pro-

vide immunization services

• Further advocacy efforts directed at re-

ligious leaders, traditional rulers, dis-

trict heads, mothers, youth, and school

children

Town Hall organizers noted two successes: a large

turnout with representatives from the community,

traditional leaders, government officials, and strong

female participation in the breakout sessions. Participants

recognized the success of recent improvements to routine

immunization efforts.

Participants sign in at the Nasarawa State Town Hall hosted by Vaccine Network for Disease Control & National Council for Women’s Societies.

“[The Town Hall meeting] brought

together all the tribes of Nigeria in one pot.

We had Gbagi women’s associations, Igbo women’s

association, pepper sellers association, Fulani

women’s association, Nomadic women’s

association, Yoruba women’s association, Muslim

women’s association among others we never

imagined would show up.”

—Town Hall Meeting participant,Lafia, Nasarawa

Mothers tell their stories at Imo State Town Hall hosted by the Health Reform Foundation of Nigeria.

Presentation at the Imo State Town Hall hosted bythe Health Reform Foundation of Nigeria.

Community voices:

“We strongly believe in

immunization. It has

helped to reduce

childhood diseases.”


South East Zone

Owerri, Imo StateHosted by the Health Reform Foundation of Nigeria

March 22, 2012

The South East Zone Town Hall was hosted by the Health Reform Foundation

of Nigeria (HERFON) in Owerri, Imo State. The aim of the Town Hall meeting

was to identify barriers to immunization, articulate local opinion concerning

vaccination in the South East Zone, and to declare a Call to Action to improve

vaccine access and utilization.

Over 300 people attended the Town Hall, which was chaired by The First

Lady of Imo State, Her Excellency Mrs. Nkechi Rochas Okorocha. Participants

included political leaders, immunization activists, commissioners of health,

women from trade associations, traditional and religious leaders, youth or-

ganizations, and the media.

Chairman of Imo State Council of Traditional Rulers, HRH Eze Samuel

Agunwa Ohiri, pledged the support of the traditional institution for full im-

munization of mothers and children in South East Zone. Dr. Okeagu, director

PHC Imo State, presented a new Imo State health initiative called “Health at

Your Door Step,” which aims to improve vaccine access and utilization in

communities.

Participants were excited to participate in discussions about challenges and

opportunities in routine immunizations. The opinion on routine immu-

nization services across the states in the South East Zone is generally a

positive one. Town Hall participants observed that routine immunization

in South East Zone is currently hampered by factors such as inadequate

transportation of vaccine supplies, poor community participation, and

low capacity of health care workers especially in rural areas.


North West Zone

Kaduna, Kaduna StateHosted by Women of Purpose

April 13, 2012

Women of Purpose organized the Town Hall event for the North West Zone

in the city of Kaduna, Kaduna State. Over 300 people attended the town hall,

including local government health officials, traditional and religious lead-

ers, physicians, midwives, teachers, and students.

An opening address, given by Dr. Nonnie Roberson,

head of Women of Purpose, highlighted the benefits

of childhood immunizations and urged mothers,

community members, and religious leaders to join

hands with health institutions and the govern-

ment to deliver this message.

During the breakout and feedback sessions, par-

ticipants cited lack of publicity around routine im-

munization programs as the biggest challenge to

immunization in the North West Zone. They consid-

ered the public education and awareness efforts through

radio, television, and print media to be largely aimed at the

educated urban areas, bypassing the rural communities.

At the end of the town hall, participants developed recommendations for how

government and donors can ensure rural communities are effectively reached

by public awareness campaigns.

Barriers to Vaccine Access:

“Some people believe vaccines

prevent children [from being able]

to reproduce later.”

“Vaccines are more [often]

available in private clinics.”

Public & Private Sector Partners

Abuja, Federal Capital Territory Hosted by the National Primary Health Care Development Agency

March 28, 2012

The Nigerian Private Sector Consultative Forum and Town Hall Meeting on

Vaccines, Immunization, and Primary Health Care took place in Abuja. The

aim of this forum was to galvanize the support of the Nigerian private sector

in strengthening immunization and primary health care.

Top executives from Nigeria’s private sector and civil society organizations

in Nigeria attended, including members of the pharmaceutical, hospital,

and media sectors as well as civil society organizations and senior gov-

ernment officials.

The Executive Director of the National Primary Health Care Development

Agency (NPHCDA), Dr. Ado J.G. Muhammad, opened the forum with a

keynote address. Goodwill messages were delivered by the Managing Di-

rector GlaxoSmithKline, Lekan Asuni and representatives from the Pae-

diatrics Association of Nigeria, National Orientation Agency, and other

civil society organizations.

Presentations focused on the following topics: the role of Nigeria Private

Sector in immunization and primary health care delivery; suggested pack-

ages for support by the Nigeria private sector; and immunization delivery

as a collective responsibility, its overall health benefits and national eco-

nomic development.

An interactive feedback session focused on

four key thematic areas: 1) access to

vaccines and immunization, 2) supply, 3)

demand for vaccines and immunization,

and 4) governance/accountability.

The participants observed that improved

routine immunization in Nigeria is cur-

rently hampered by factors such as: inade-

quate funding, inadequate cold chain

capacity, poor performance management,

transportation challenges at all points, in-

consistent health policies by governments,

and lack of community engagement,

among several other challenges.

At the end of the Town Hall, participants

identified action steps to leverage private

sector strengths for vaccines and immu-

nization and primary health care delivery

in Nigeria. The forum was successful in in-

spiring new commitment for supporting

vaccines and immunization programs in

Nigeria by the Nigerian Private Sector.

Business and government leaders at the Public & Private Sector Partners Town Hall hosted by the

National Primary Health Care Development Agency.



Recommendations made by the participants of the Public & Private Sector Town Hall:• The Nigerian government must increase engagement of the

Private Sector through the Public Private Partnership

(PPP) Policy for Health, especially concerning immu-

nization and primary health care delivery.

• Create a road map for the implementation of PPP

health projects with clearly defined outcomes.

• Build capacity for health personnel and volunteers

on vaccines and immunization programmes.

• To ensure adequate cold chain for vaccines to main-

tain their potency, government should leverage the

private sector, especially pharmaceutical companies

that have structures in the communities nationwide.

• Personnel of pharmaceutical companies, other private

sector officials/ firms, and health representatives should be

engaged in vaccine distribution and management of cold

chain systems in the various communities.

• Pharmaceutical companies and the private sector should sponsor health

programs on the media to sensitize the public about the benefits of rou-

tine immunization.

• A Vaccine Adverse Events Monitoring Committee should be put in place

to monitor their use and archive reports concerning AEFI for further/fu-

ture handling.

• Government should identify the strengths of key stakeholders in the pri-

vate sector to address gaps in the routine immunization landscape.

• National Orientation Agency should work with media in rural

communities and to educate people to dispel myths associated with vac-

cines and immunization.

• Messages involving immunization and other clinical/health technical

matters should be finalized before disseminating to the target audience

to avoid misconceptions.

• Government should work with the private sector to improve the current

immunization coverage by providing the following: financial guarantees,

transport/logistics and distribution, provision of solar power/alternative

energy sources, satellite cold storage centers, data checks, and improved

collaboration with traditional rulers, religious, and community leaders.

• The Private sector pledges to partner in training and re-training of health

personnel in both government and private sector to build their capacities

on vaccines and immunization.

• Government should create an enabling environment for private

sector participation in vaccines, immunization, and primary health care

delivery in Nigeria.

“The Private sector

pledges to partner in

training and re-training of

health personnel in both

government and private

sector to build their capacities

on vaccines and

immunization.”

South South Zone

Benin City, Edo StateHosted by Solina Health Ltd.

March 29, 2012

As part of activities leading to Nigeria’s National Vaccine Summit, Solina

Health Limited, a health systems consulting firm, partnered with University

of Benin to host a youth focused Town Hall meeting on routine immuniza-

tions in Nigeria at the University of Benin. About 120 people attended the

event, which was facilitated by Dr. Muyi Aina of Solina Health. Participants

included students, staff, and faculty from the University of Benin’s Teaching

community health and public health departments.

The objectives of this Town Hall were to increase the level of interest, excite-

ment, and understanding about routine immunization among youth. It also

served to generate a consensus statement from the youth, highlighting prob-

lems behind the zone’s low immunization coverage.

Youth leaders participated as panelists, sharing their observations on the prob-

lems of routine immunization in Nigeria, followed by fielding questions from

the audience. Ineffective and poorly implemented government policies were

suggested to be the biggest challenge for routine immunization. Participants

stated that even when policies are appro-

priate and well defined, there is inadequate

follow-through at the community level

service delivery points. And among the

public, routine immunization is not per-

ceived to be one of the top priorities of the

government.

The Town Hall was successful in engaging

youth in vaccine advocacy. Youth commit-

ted themselves to become immunization

ambassadors for their various communi-

ties, through advocacy and “spreading the

word.” They also agreed to volunteer their

time to directly participate in immuniza-

tion activities and support health facilities

in their communities.

Youth ask questions at Edo State Town Hall hosted by Solina Health Ltd.


Youth distributes information about the Edo State Town Hall hosted by Solina Health Ltd.


“Youth can be a lot more

engaged by volunteering them-

selves for service at local health

centers, both for health-

related tasks and non health-related

tasks, e.g., providing engineering-

related volunteer services to

support health facilities.”

Youth opinions on the challenges for routine immunization in Nigeria: • Government policies are not being implemented

• Shortage, insufficient training, and lack of accountability

among health workers

• No consequences for parents who do not get their

children vaccinated

• Low demand for vaccines due to poor understanding about the

benefits of vaccination at the community level

“Contrary to common belief, immunization

has become very important to youth because

of its potential to impact not just domestic

health of the population but diplomatic

relations…. A paramount example was the

recent row between Nigeria and South Africa

due to immunization records of travelers.

“Youth need to ask

more questions – of their

parents, professors who inform

policy, local politicians, and even

healthcare facility staff

regarding performance of RI

in their localities.”

North East Zone

Jalingo, Taraba StateHosted by Silver Lining for the Needy Initiative

April 4, 2012

The Silver Lining for the Needy Initiatives (SLNI) hosted the

North East Zone Town Hall meeting on routine immuniza-

tion in Jalingo, Taraba State. Opening statements were given

by the First Lady of Taraba State, Dr. Hauwa Danbaba Suntai,

Hon. Prince Mustapha Gabdo, Commissioner of

Health in Taraba, and Miss Hauwa Abbas,

founder of the host organization SLNI.

The aim of this Town Hall was to en-

gage the Taraba grassroots community

and provide them an opportunity to

voice their concerns about routine im-

munizations, their challenges and suc-

cesses, and ways to move forward. The

meeting was well attended, drawing pro-

gram and policy makers, service providers,

private sector, traditional leaders, women’s

groups, students from Taraba University, and representa-

tives from the Children’s Parliament.

During the Town Hall breakout sessions, participants discussed the benefits

of routine immunization for themselves, their families, and their community.

Women most especially wanted support from their husbands and employers

to allow the time to ensure that their children are vaccinated. They discussed

the roles that community leaders should play and committed themselves to

making good health decisions for their families. Participants cited the need

for more community health workers and regular retraining to ensure their

work is effective and efficient.

Thoughts and suggestions fromthe North East Zone:• Include traditional and religious

leaders in the routine immunization

system

• Vaccines should be available within

communities, not just at hospitals

(e.g. visits by health workers to

administer vaccines)

• Participants said people are generally

suspicious of the fact that

government provides only free

vaccines, while other drugs must be

purchased, and other health services

are not functioning at all

• Every participant personally knew

someone who had lost a child to a

vaccine-preventable disease


“This event drew the attention of the whole State.

Program and policy makers, serviceproviders, private sector, traditional lead-

ers, various women groups such as NCWS,FOMWAN, CAN, FIDA, Market Women

Association, students from the Taraba University,and also representatives from the Children’s

Parliament were all in attendance…The voiceof the people of Taraba State was heard

during this Town Hall meetingand will be carried for-

ward.”From the mothersof Taraba State:

“Our husbands and employersshould support us by giving uspermission and time to get our

children vaccinated.”

“Health workers need training to give us the

right message.”

From left to right: Wife of the Deputy Governor of Taraba State,Wife of Taraba State governor, Commissioner of Women Affairsat Town Hall hosted by the Silver Lining for the Needy Initiative.


North East Zone

Maiduguri, Borno StateHosted by Evolve Worldwide

April 7, 2012

The North East Zone Town Hall event with the theme “Vaccines: save life,

save money, and build a nation” was hosted in Maiduguri, Borno State by

Evolve Worldwide. One of the meeting’s objectives was to encourage local of-

ficials to begin forming an action plan to improve access to routine immu-

nization. Village, ward, district, religious, political leaders, and health officials

were represented.

Discussion centered on the health systems and socio-cultural challenges of

vaccines in the zone. Participants cited misconceptions about vaccines as an

impediment to their uptake. The event also included presentations and dis-

cussion on the health benefits and safety of vaccines.

Suggestions and questions raised byparticipants at the Town Hall: • Free medical care should be pro-

vided for children under five years

old, this would lead to uptake of vac-

cine services

• A religious leader suggested that pre-

ventative medicine is an

ancient practice. He promised to en-

courage his peers to recommend vac-

cines using this reasoning

• A question was posed as to why vac-

cines are free but simple

medicines are not

• One participant asked the appropri-

ate ages for vaccination

• Another participant asked whether

there were dangers associated with

receiving multiple vaccinations

• Participants were also interested in

knowing more about the

Muslim perspective on immuniza-

tion

Challenges with routine immuniza-tion in Borno State:• Cultural attitudes and fear of vac-

cines and their side effects

• Lack of commitment from leadership

at the grassroots level

• Lack of health care providers at the

grassroots level

• Inadequate logistical (cold chain) ca-

pacity and stock outs

Town Hall event in Borno Statehosted by Evolve Worldwide.

Looking Forward

Nigeria stands to make rapid improvements in child survival by promoting

vaccination as part of a package of interventions to prevent and treat infectious

disease. Introduction of new vaccines is a crucial part of this strategy, and for

Nigeria this includes the ongoing rollout of pentavalent vaccine, and planned

introduction of pneumococcal conjugate and rotavirus vaccines. But equally

important are efforts to extend coverage of these and other routine immu-

nizations to the children and families currently without access.

Understanding the strengths and weaknesses of Nigeria’s routine immuniza-

tion system is crucial to improving vaccine delivery and uptake. The National

Vaccine Summit and Town Hall Series helped to outline these challenges and

opportunities by giving Nigerians a voice and bringing together stakeholders

from various fields. Another step in this direction is a recent study, the Land-

scape Analysis of Routine Immunization, conducted by the International Vac-

cine Access Center at the Johns Hopkins Bloomberg School of Public Health.

Mrs. Chika Offor, Director of Vaccine Network for Disease Control (VNDC) and a participantat the Nasawara Town Hall hosted by VNDC and the National Council for Women's Societies.


This study has helped to identify the bar-

riers to routine immunization and strate-

gies likely to improve service delivery and

vaccine uptake in Nigeria.

The commitments made by Nigeria’s lead-

ers at the 1st National Vaccine Summit are

impressive, and if implemented, will save

lives, avert costs, and boost economic pro-

ductivity. There is strong support for im-

munization among Nigeria’s traditional,

religious, and political leaders and policy

makers, particularly among the National

Primary Health Care Development Agency

and the Ministry of Health.

One of the major achievements of Town

Hall series was the confirmation that the

people of Nigeria are firmly behind the

Call to Action for immunization. By par-

ticipating in Town Hall meetings across

Nigeria, they have contributed to the na-

tional movement to reduce child mortality.

These Town Halls are only a beginning; the

conversation with the Nigerian people will

continue as the Government of Nigeria

and its partners put plans from the 1st Na-

tional Vaccine Summit into action.

The people of Nigeria

are firmly behind the

Call to Action for

immunization.


• Bill & Melinda Gates Foundation

• Centre for Health Sciences Training, Research and

Development (CHESTRAD)

• European Union Delegation to Nigeria

• Evolve Worldwide

• GAVI Alliance

• Health Reform Foundation of Nigeria (HERFON)

• International Vaccine Access Center

• National Council of Women’s Societies

• National Orientation Agency

• National Primary Health Care Development Agency

• Nigeria Federal Ministry of Health

• Nigeria Television Authority

• Paediatric Association of Nigeria

• Pharmaceutical Society of Nigeria

• Rotary International

• Silver Lining for the Needy Initiative

• Solina Health Limited

• United Nations Children’s Fund (UNICEF)

• United States Agency for International Development

(USAID)

• Vaccine Network for Disease Control

• Women of Purpose

• World Health Organization (WHO)

1st National Vaccine Summit Partners

www.nigeriavaccinesummit.org

855 NORTH WOLFE STREET • SUITE 600 • BALTIMORE, MD 21205EMAIL: [email protected] • WWW.JHSPH.EDU/IVAC

Johns Hopkins Bloomberg School of Public HealthInternational Vaccine Access Center (IVAC)

Report written by Daniel Erchick and Chizoba Wonodi.Report writing and production supported by a grant from the Bill and Melinda Gates Foundation to the International Vaccine Access Center.

©2012 International Vaccine Access Center (IVAC) at Johns Hopkins Bloomberg School of Public Health. All rights reserved.

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